Australia Life Insurance Code of Practice (CALI Life Code)
The Australian life insurance industry's conduct code: product design and medical definition reviews, honest advertising and documented sales rules, plain-language documents and notices, proportionate underwriting with mental health, genetic and HIV safeguards, claims decided in two or six months with controlled interviews and surveillance, support for vulnerable and hardship-affected customers, thirty-day complaint responses, and compliance reporting and significant breach notification to the Life Code Compliance Committee.
Australia Life Insurance Code of Practice (CALI Life Code) is a compliance framework from Australia with 8 domains and 67 controls. The largest domains are Section 5: claims handling, investigations and decisions – Australia Life Insurance Code of Practice (CALI Life Code) (16 controls), Section 2: policy design, advertising and sales standards – Australia Life Insurance Code of Practice (CALI Life Code) (12 controls), Section 4: underwriting, offering insurance and policy cancellations – Australia Life Insurance Code of Practice (CALI Life Code) (12 controls). Every control below carries what it requires and what an assessor expects to see.
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Framework Domains (8)
Section 1: aims, scope, insurers, reinsurers and independent service providers – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::1.13-1.14 | Ensure staff and authorised representatives comply when acting for the insurer |
| australia-life-insurance-code-of-practice-cali-life-code::1.16-1.17 | Reinsurance arrangements consistent with the Code's principles |
| australia-life-insurance-code-of-practice-cali-life-code::1.18-1.19 | Service agreements with independent service providers carry the Code standards |
| australia-life-insurance-code-of-practice-cali-life-code::1.20-1.21 | Medical assessors registered and bound by ethical guidelines; complaints about providers handled |
| australia-life-insurance-code-of-practice-cali-life-code::1.22-1.24 | Provider contracting criteria, expert witness codes and impartial medical reports |
| australia-life-insurance-code-of-practice-cali-life-code::1.3 | Make the Code visible on the website and point customers to it at claim and complaint |
Section 2: policy design, advertising and sales standards – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::2.1-2.2 | Design products for a genuine need in the target market and review the target market every three years |
| australia-life-insurance-code-of-practice-cali-life-code::2.11 | Advertising that is clear, not misleading and consistent with the product design |
| australia-life-insurance-code-of-practice-cali-life-code::2.12-2.14 | Documented sales rules that prevent pressure selling and sales to those who cannot claim |
| australia-life-insurance-code-of-practice-cali-life-code::2.15-2.17 | Monitor staff and authorised representatives against the sales rules |
| australia-life-insurance-code-of-practice-cali-life-code::2.18-2.19 | Ongoing role-appropriate sales training with defined content |
| australia-life-insurance-code-of-practice-cali-life-code::2.20-2.21 | Remuneration aligned to good customer outcomes; distributor processes consistent with the Code |
| australia-life-insurance-code-of-practice-cali-life-code::2.22-2.26 | Investigate sales practice concerns and remedy unacceptable sales |
| australia-life-insurance-code-of-practice-cali-life-code::2.27-2.28 | Rules for verbal and face-to-face direct sales |
| australia-life-insurance-code-of-practice-cali-life-code::2.29-2.31 | Funeral insurance explained in plain language, premium structures and first-premium notice |
| australia-life-insurance-code-of-practice-cali-life-code::2.3-2.5 | Plain language, consumer-tested documents and inflation-linked increases with an opt-out |
| australia-life-insurance-code-of-practice-cali-life-code::2.32-2.36 | Consumer credit insurance: clear information, explicit consent, refund window and financing disclosures |
| australia-life-insurance-code-of-practice-cali-life-code::2.7-2.9 | Review medical definitions every three years and assess claims against current medical practice |
Section 3: communicating with customers – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::3.1-3.3 | Use the customer's preferred communication method and respect who owns the policy |
| australia-life-insurance-code-of-practice-cali-life-code::3.10-3.12 | Written notice before each policy anniversary |
| australia-life-insurance-code-of-practice-cali-life-code::3.13-3.14 | Tell customers when a Code deadline is missed for third-party reasons and when information is withheld |
| australia-life-insurance-code-of-practice-cali-life-code::3.15 | Tell the customer within ten business days of finding an error that disadvantaged them |
| australia-life-insurance-code-of-practice-cali-life-code::3.16-3.18 | Show cause letter before varying or avoiding cover, and written confirmation after |
| australia-life-insurance-code-of-practice-cali-life-code::3.4-3.5 | Disclosure statement availability and the post-sale documentation pack |
| australia-life-insurance-code-of-practice-cali-life-code::3.6-3.9 | Premium structure information, copies of policy documents and notice of automatic upgrades |
Section 4: underwriting, offering insurance and policy cancellations – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::4.10-4.11 | Use the agreed consent wording for health information and tell the applicant each time it is used |
| australia-life-insurance-code-of-practice-cali-life-code::4.12-4.14 | Mental health conditions: no decline without the chance to explain, and manage risk by terms rather than refusal |
| australia-life-insurance-code-of-practice-cali-life-code::4.15-4.17 | Family history questions limited and the genetic test moratorium followed |
| australia-life-insurance-code-of-practice-cali-life-code::4.17A-C | HIV: no questions about sexual practices, treat HIV like any other condition and publish underwriting information |
| australia-life-insurance-code-of-practice-cali-life-code::4.18-4.19 | Underwriters demonstrate competence before deciding and access specialist advice |
| australia-life-insurance-code-of-practice-cali-life-code::4.2-4.3 | Ask only for health information reasonably needed and decide within five business days once sufficient |
| australia-life-insurance-code-of-practice-cali-life-code::4.20-4.22 | Acceptance, temporary cover and alternative terms communicated within five business days with plain reasons |
| australia-life-insurance-code-of-practice-cali-life-code::4.23-4.24 | Warn replacing customers not to cancel existing cover and explain the general risks of replacement |
| australia-life-insurance-code-of-practice-cali-life-code::4.25-4.27 | Declined applications explained with reasons, access to the information relied on and review rights |
| australia-life-insurance-code-of-practice-cali-life-code::4.28-4.31 | Cooling-off told, refunds within fifteen business days, no retention pressure and reinstatement options explained |
| australia-life-insurance-code-of-practice-cali-life-code::4.4-4.8 | Underwriting medical examinations: examiner standards, costs, gender choice and report deadlines |
| australia-life-insurance-code-of-practice-cali-life-code::4.9 | Request extra underwriting information early, explain why and allow a review of the request |
Section 5: claims handling, investigations and decisions – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::5.1-5.4 | Treat claimants with empathy, never discourage a claim, help gather information and support income claimants |
| australia-life-insurance-code-of-practice-cali-life-code::5.12-5.17 | Claims information: fresh consent per claim, proportionate requests, limited verification of unrelated history, online information and income claim rules |
| australia-life-insurance-code-of-practice-cali-life-code::5.18-5.23 | Independent medical examinations: choice of doctor, costs, frequency limit and twenty-day reports |
| australia-life-insurance-code-of-practice-cali-life-code::5.24-5.29 | Interviews: documented reasons, senior approval, monitored interviewers, language and support arrangements |
| australia-life-insurance-code-of-practice-cali-life-code::5.30-5.39 | Conduct of interviews: information sheet, ninety-minute limit, breaks, no fraud allegations, repeat interview rules |
| australia-life-insurance-code-of-practice-cali-life-code::5.40-5.41 | Resolve inconsistencies without surveillance first; senior approval before any surveillance |
| australia-life-insurance-code-of-practice-cali-life-code::5.42-5.44 | Investigator instructions, conduct limits, four-month cap, protected places and people, and stop on health evidence |
| australia-life-insurance-code-of-practice-cali-life-code::5.45-5.46 | Claims assessors demonstrate competence and are not paid on claims outcomes |
| australia-life-insurance-code-of-practice-cali-life-code::5.47-5.52 | Decide income claims within two months and lump sum claims within six, notify within fifteen business days of completion |
| australia-life-insurance-code-of-practice-cali-life-code::5.5-5.7 | Claim information within ten business days, progress updates at least every twenty, responses within ten |
| australia-life-insurance-code-of-practice-cali-life-code::5.53-5.58 | Rehabilitation conditions, probate, provider report deadlines, two follow-ups before closure, reopening and the content of a decline |
| australia-life-insurance-code-of-practice-cali-life-code::5.59-5.60 | Circumstances beyond the insurer's control: written explanation before the deadline, senior review at twelve months |
| australia-life-insurance-code-of-practice-cali-life-code::5.61-5.62 | Suggest independent advice on large lump sums and commutation offers |
| australia-life-insurance-code-of-practice-cali-life-code::5.63-5.65 | Pay ongoing income benefits on time, warn of late payment, and do not withhold during non-disclosure investigations without evidence |
| australia-life-insurance-code-of-practice-cali-life-code::5.66-5.67 | Trauma and critical illness claims assessed under the better of the policy and the Code's current medical definitions |
| australia-life-insurance-code-of-practice-cali-life-code::5.8-5.11 | Three months' notice of benefit period expiry, definition changes and benefit reductions; group claim contacts |
Section 6: customers experiencing vulnerability or financial hardship – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::6.1-6.5 | Recognise vulnerability, take extra care, record support needs and guard against gratuitous concurrence |
| australia-life-insurance-code-of-practice-cali-life-code::6.15-6.17 | Vulnerability policies and training, cultural awareness training and flexibility for remote communities |
| australia-life-insurance-code-of-practice-cali-life-code::6.18-6.23 | Financial hardship: contact with flexible options, explain the effects, warn before options end, ask for proportionate evidence |
| australia-life-insurance-code-of-practice-cali-life-code::6.24-6.28 | Help with the claims process and assess requests for urgent access to benefits within five business days |
| australia-life-insurance-code-of-practice-cali-life-code::6.6-6.8 | Published family violence policy, interpreter training and accessible website links |
| australia-life-insurance-code-of-practice-cali-life-code::6.9-6.14 | Provide extra support early, recognise representatives and support people, pay for interpreters and flex identification requirements |
Section 7: complaints – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::7.1-7.6 | Never discourage complaints; acknowledge within one business day; independent handler; relevant information only |
| australia-life-insurance-code-of-practice-cali-life-code::7.10-7.12 | Quick closure only where resolved or explained within five business days; written responses where required |
| australia-life-insurance-code-of-practice-cali-life-code::7.13-7.15 | Final written response within thirty calendar days with reasons, documents on request and the external dispute right |
| australia-life-insurance-code-of-practice-cali-life-code::7.16-7.19 | Complaints about trustee-owned policies: forty-five day trustee responses and the insurer's decision routed through the trustee |
| australia-life-insurance-code-of-practice-cali-life-code::7.7-7.9 | Final decisions on claim complaints state the claim outcome and the assessor on any reopening |
Section 8: Life Code governance, breaches and sanctions – Australia Life Insurance Code of Practice (CALI Life Code)
| Code | Title |
|---|---|
| australia-life-insurance-code-of-practice-cali-life-code::8.11 | Compliance systems, yearly compliance reporting to the Life CCC and board-level governance |
| australia-life-insurance-code-of-practice-cali-life-code::8.12-8.13 | Breach through staff or representatives; report significant breaches within thirty business days |
| australia-life-insurance-code-of-practice-cali-life-code::8.16 | Cooperate with Life CCC reviews and investigations and complete agreed corrective actions on time |
What is Australia Life Insurance Code of Practice (CALI Life Code) and who does it apply to?
Australia Life Insurance Code of Practice (CALI Life Code) is a compliance framework from Australia with 8 domains and 67 controls. The Australian life insurance industry's conduct code: product design and medical definition reviews, honest advertising and documented sales rules, plain-language documents and notices, proportionate underwriting with mental health, genetic and HIV safeguards, claims decided in two or six months with controlled interviews and surveillance, support for vulnerable and hardship-affected customers, thirty-day complaint responses, and compliance reporting and significant breach notification to the Life Code Compliance Committee. It is used by organisations to establish and maintain compliance with industry standards and regulatory requirements.
What does Australia Life Insurance Code of Practice (CALI Life Code) actually require?
Australia Life Insurance Code of Practice (CALI Life Code) has 67 controls organised across 8 domains. The largest domains are Section 5: claims handling, investigations and decisions – Australia Life Insurance Code of Practice (CALI Life Code) (16 controls), Section 2: policy design, advertising and sales standards – Australia Life Insurance Code of Practice (CALI Life Code) (12 controls), Section 4: underwriting, offering insurance and policy cancellations – Australia Life Insurance Code of Practice (CALI Life Code) (12 controls). Each control defines specific requirements that organisations must implement to achieve compliance.
If I already comply with another framework, how much of Australia Life Insurance Code of Practice (CALI Life Code) do I already cover?
Australia Life Insurance Code of Practice (CALI Life Code) does not currently have cross-framework mappings in our system. Check back as we continuously expand our mapping database.
How do I implement Australia Life Insurance Code of Practice (CALI Life Code)?
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